Labour urges GPs to step up fight against Health Bill

There is 'no evidence anywhere in the world' that a market provides better care or value for money in health, shadow health secretary John Healey tells GP.

John Healey: 'If you want patients to be more involved, you could bring them into the process, which isn't happening in these reforms' (Photograph: M Weeks)
John Healey: 'If you want patients to be more involved, you could bring them into the process, which isn't happening in these reforms' (Photograph: M Weeks)

Herein lies the problem for Mr Healey as he attempts to savage the government's health reforms - the market-based NHS has advanced under Labour for the last decade.

Health secretary Andrew Lansley often highlights Labour's support for practice-based commissioning, its support for 'choice' and versions of the 'any willing provider' policy, and its pledge to move all hospitals to foundation trust status when the party criticises the current reforms.

The fact Labour initiated many of these policies 'makes the arguments against reform harder to make clearly', admits Mr Healey.

But he says the government is disguising much more radical policies by 'using the same words' as Labour did.

He says Labour only used a market 'to build additional capacity' or 'when the NHS needed someone to step in and innovate' - while the current government's Health Bill will usher in a 'full-blown' market.

'It may work for some services or products, but every feature required for a well-functioning market is not there in health,' he says.

He shares the BMA's view that Monitor's new power to enforce competition law will prevent GPs collaborating with NHS colleagues in other sectors. The reforms will lead to hospitals failing, he says.

'Some of the great advances in the NHS have come from integration. If you look at Monitor's powers and the health and wellbeing boards' powers, which are supposed to encourage integration, you can see who has the whip-hand.'

Is he confident he can change the Bill? It will be a 'big challenge,' he says, given the coalition's majority, and despite the fact that the government lacks a majority in the House of Lords.

But he believes his opposite number is now on the defensive. 'Andrew Lansley's language has changed since last summer from "radical and revolutionary" to this evolution of existing policies,' he says.

The Bill, a 'slow-burn political problem' for the government, is being rushed through parliament 'at breakneck speed' he warns.

Sources in Labour's team believe there are several Liberal-Democrat MPs considering voting against the reforms, although none did in the first vote last week.

'Most LibDems haven't looked at the Bill,' says Mr Healey. He thinks GPs and their representatives must do more to build pressure against key aspects of the reforms.

'GPs have to make clear, much more strongly and publicly, their doubts that these are the right decisions. This way, pressure to remove the sharpest edges of the Bill will grow,' he says.

Those crucial Liberal Democrat MPs could turn once the pressure and letters from constituents build up, he says.

Frustratingly for those that want to see a more robust campaign from Labour against the reforms, he 'generally agrees with the aims of the Bill'. But much like the RCGP, he thinks Mr Lansley's aims could be achieved in a less risky way.

'If you wanted GPs to lead commissioning, you could turn PCT boards over to them. If you want patients genuinely to be more involved, you could bring them into the process, which isn't happening in these reforms. And you wouldn't take all your NHS organisations out of the obligations of accountability.'

Compared with the well-versed Mr Lansley, Mr Healey is still learning the ropes. His answers lack the local anecdotes and practical clinical examples Mr Lansley often illustrates his arguments with.Nonetheless, he'll be 'arguing hard for two days' next time MPs debate the Bill.

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